The impact of age of presentation on lung cancer staging
Primary lung cancer is the commonest cause of cancers and the most common cause of death due to cancer worldwide. The Tumor Node Metastases (TNM) staging for non-small cell lung cancer (NSCLC) helps to prognosticate and plan for treatment. Most patients have advanced disease at the time of diagnosis.
Primary lung malignancy was previously diagnosed mostly in older individuals. The primary aim of this study was to determine if younger age at presentation is a risk factor for more advanced disease. We defined the younger age group as less than 45 years of age.
This was a retrospective analytical study covering five and a half years. The information was obtained from lung cancer registry of all patients that were presented at the Pulmonology department weekly combined oncology meeting.
A total of 52 out of 1083 patients with lung malignancy were younger than 45 years, and 48 of them had NSCLC. Adenocarcinoma was the predominant type (48%), followed by squamous cell carcinoma (27%), NSCLC Not Otherwise Specified (NOS) (21%), and large cell carcinoma (4%). Overall, majority (98) % had advanced disease at presentation. However there was no statistical difference compared to presenting stage in older patients, Odds Ratio (OR) 0.25, 95% Confidence interval (CI) (0.034-1.87), and the Risk Ratio (RR) was 0.27 95% CI (0.038-1.9).
Primary lung malignancy remains a disease of the elderly. This study demonstrated that NSCLC tends to present in advanced stages in younger patients, although the difference was not statistically significant.
Nontembiso Aphiwe Mhlana, Tygerberg Hospital, Stellenbosch University
Coenraad FN Koegelenberg, Tygerberg hospital, Stellenbosch university
Gregory Calligaro, University of Cape Town
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Date published: 2020-06-15
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African Journal of Thoracic and Critical Care Medicine| Online ISSN: 2617-0205
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